Shen Xiaoran, Guo Hongliang, Mantica Guglielmo, Yuan Hui
Department of Clinical Laboratory Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
IRCCS Ospedale Policlinico San Martino, Genova, Italy.
J Thorac Dis. 2023 Jul 31;15(7):3934-3943. doi: 10.21037/jtd-23-1016. Epub 2023 Jul 25.
Heart failure (HF) often leads to kidney injury and increased morbidity and mortality. Factors contributing to kidney injury in HF patients had not been elucidated completely. This study sought to comprehensively evaluate the risk factors and clinical features of kidney injury in patients with chronic heart failure (CHF) and to provide more evidence for the management of these patients.
Adult patients with CHF admitted to Beijing Anzhen Hospital, Capital Medical University from January 2022 to May 2022 were included in this study. The primary endpoints were the independent risk factors for the development of kidney injury. A multivariate logistic regression model was used for the exploration of the risk factors.
A total of 193 patients were included in this study, of whom 86 (44.5%) developed kidney injury. The independent risk factors for kidney injury in patients with CHF included sex (male) [odds ratio (OR): 4.30, 95% confidence interval (CI): 1.72-10.7, P=0.001], hypertension (OR: 3.68, 95% CI: 1.64-8.29, P=0.001), and stroke (OR: 3.82, 95% CI: 1.25-11.6, P=0.01). Kidney injury was significantly positively correlated with age (OR: 1.03, 95% CI: 1.008-1.06, P=0.01) and potassium (OR: 3.70, 95% CI: 1.58-8.67, P=0.002), and significantly negatively correlated with angiotensin receptor blocker (ARB) application (OR: 0.26, 95% CI: 0.11-0.61, P=0.001), serum albumin concentration (OR: 0.88, 95% CI: 0.81-0.96, P=0.005), hemoglobin concentration (OR: 0.97, 95% CI: 0.95-0.99, P=0.006), and left ventricular ejection fraction (LVEF; OR: 0.95, 95% CI: 0.92-0.98, P=0.01).
Kidney injury occurred in more than half of the patients with CHF during hospitalization. The independent risk factors for kidney injury in the CHF patients included sex (male), hypertension, and stroke. Kidney injury was positively correlated with age and serum potassium, and negatively correlated with serum albumin, hemoglobin concentration, LVEF, and ARB application.
心力衰竭(HF)常导致肾损伤,并增加发病率和死亡率。HF患者发生肾损伤的因素尚未完全阐明。本研究旨在全面评估慢性心力衰竭(CHF)患者肾损伤的危险因素和临床特征,为这些患者的管理提供更多依据。
纳入2022年1月至2022年5月在北京安贞医院住院的成年CHF患者。主要终点是发生肾损伤的独立危险因素。采用多因素logistic回归模型探索危险因素。
本研究共纳入193例患者,其中86例(44.5%)发生肾损伤。CHF患者发生肾损伤的独立危险因素包括性别(男性)[比值比(OR):4.30,95%置信区间(CI):1.72 - 10.7,P = 0.001]、高血压(OR:3.68,95% CI:1.64 - 8.29,P = 0.001)和卒中(OR:3.82,95% CI:1.25 - 11.6,P = 0.01)。肾损伤与年龄(OR:1.03,95% CI:1.008 - 1.06,P = 0.01)和血钾(OR:3.70,95% CI:1.58 - 8.67,P = 0.002)呈显著正相关,与血管紧张素受体阻滞剂(ARB)应用(OR:0.26,95% CI:0.11 - 0.61,P = 0.001)、血清白蛋白浓度(OR:0.88,95% CI:0.81 - 0.96,P = 0.005)、血红蛋白浓度(OR:0.97,95% CI:0.95 - 0.99,P = 0.006)和左心室射血分数(LVEF;OR:0.95,95% CI:0.92 - 0.98,P = 0.01)呈显著负相关。
超过一半的CHF患者在住院期间发生肾损伤。CHF患者发生肾损伤的独立危险因素包括性别(男性)、高血压和卒中。肾损伤与年龄和血清钾呈正相关,与血清白蛋白、血红蛋白浓度、LVEF和ARB应用呈负相关。